Surgery for late in-the-bag intraocular lens dislocation: long-term visual outcome in a randomised clinical trial – lens repositioning vs lens exchange

Session Details

Session Title: Cataract Surgery Complications

Session Date/Time: Monday 16/09/2019 | 16:30-18:00

Paper Time: 17:00

Venue: Free Paper Forum: Podium 2

First Author: : M.Dalby NORWAY

Co Author(s): :    O. Kristianslund   L. Drolsum                          

Abstract Details

Purpose:

To compare the long-term visual outcome of two operation methods in a randomized clinical trial for late in-the-bag intraocular lens (IOL) dislocation.

Setting:

Patients referred to Oslo University Hospital.

Methods:

We assigned 104 patients (104 eyes) either to IOL repositioning by scleral suturing (n = 54) or to IOL exchange with retropupillary fixation of an iris-claw IOL (n = 50). One surgeon performed all operations with an anterior approach. Patients were evaluated before surgery, and 2 years postoperatively (63% of the patients). The dislocation was graded in 4 stages and complete dislocation (grade 4) was excluded from the study as it requires another surgical approach. In addition to the 2-year data analysis, we performed an intention-to-treat analysis to clarify the representability and potential bias among the dropouts.

Results:

After 2 years mean corrected distance visual acuity (CDVA) in the repositioning group was 0.20 (standard deviation 0.29) logarithm of the minimum angle of resolution (logMAR) units (range, -0.18 to 1.10) and in the exchange group 0.22 (standard deviation 30) logMAR (range, -0.10 to 1.22) (P = 0.69). A CDVA of 20/40 or better (Snellen) was reached by 76% of the patients in both groups. There was no difference in 2-year visual outcome based on degree of dislocation at baseline. An intention-to-treat analysis on all randomized patients supported the main analysis and revealed no group differences.

Conclusions:

This randomized clinical trial found similar and good long-term visual outcome after surgery for late in-the-bag IOL dislocation with two different surgical approaches. The degree of dislocation at baseline (grade 1-3) did not affect the long-term visual outcome.

Financial Disclosure:

None